By Dr. Lisa Fitzsimmons
“Where the days are longer
The nights are stronger than moonshine.”
— America, “Ventura Highway”
It’s almost Summer, the time of the year when we let our inhibitions run wild, and that crazy little thing called love unfurls its fiddlehead. Summertime means strappy sandals, free-flowing dresses, and steamy nights. It’s a time to let loose, have some fun, and for some, get their love lives back on track.
Yet for many, being able to express love is a challenge. “Sexual dysfunction” is an umbrella term referring to a constellation of symptoms arising during any stage of normal sexual activity, including physical pleasure, desire or libido, arousal and orgasm.
Sexual dysfunction is a common concern in both sexes: 43% of women (and 31% of men) report experiencing sexual dysfunction at some point during their lifetimes. What gets in the way of feeling and being sexual? Perhaps a better question is what doesn’t? Causes of sexual dysfunction can be broken down into three categories: physiological, lifestyle and psychosocial. Depression, anxiety, stress and fatigue may all play a role, as can medications, sleep difficulties substance use and abuse, as well as increasing age, diabetes, metabolic syndrome, hypertension, autoimmune disorders, and hormone and neurotransmitter imbalances – to name a few from longer lists.
Perhaps these lists can be shortened to two words: imbalance and stress. Because the cascade of sexual response relies on mind and body, an imbalance in either of these essential areas may contribute to sexual dysfunction, and the factors that impact sexual dysfunction for one person are likely to be different for another. For many, stress may be the underlying factor. Stress is a response to imbalance, and imbalance leads to more stress — which has been found to be negatively associated with sexual function in both women and men. Stress can affect neurotransmitter and hormone balance, further impacting desire and drive.
Astonishingly, sexual dysfunction is not routinely addressed in clinical practice — only 35% of providers take a sexual history at least 75% of the time! Initiating a conversation about sexual health and/or including a sexual functioning questionnaire as part of the patient intake, as well as including comprehensive neuroendocrine assessments to identify potential hormone and neurotransmitter imbalances, can help both the provider and patient identify causes and contributions to dysfunction. Successful treatment of these concerns requires addressing multiple lifestyle factors (lifestyle, underlying medical problems and psychosocial concerns) while laying a strong foundation for individualized hormone and neurotransmitter balancing.
This is the fun and free time of year, so give yourself a hand and talk to your medical practitioner if you’re feeling out of touch with your love life. There are easy ways to get back in balance, reduce your stress life and increase your love life — stress is not sexy, but you are!
Dr. Lisa Fitzwilliams is a 30-year veteran in Functional Medicine located in Carbondale, Colorado. Functional Medicine looks to the underlying cause of disease and disease prevention, not merely focusing on symptoms and diagnosis of disease.
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